■没有关于阻塞性睡眠呼吸暂停(OSA)患者使用β受体阻滞剂与死亡率或心血管结局之间的关联的真实证据。我们旨在研究使用β受体阻滞剂对OSA患者全因死亡率和心血管疾病（CVD）的影响。
我们使用IMRD-UK数据库（以前称为THIN数据库），对2000年1月1日至2021年11月30日期间的37581例新诊断OSA患者进行了一项目标试验模拟研究。我们比较了在一年内开始β受体阻滞剂治疗与非β受体阻滞剂治疗的治疗策略。协变量，包括患者人口统计学，生活方式,合并症,和最近的药物，被测量和控制。对患者进行全因死亡率或复合CVD结局的随访（心绞痛，心肌梗塞,中风/短暂性脑缺血发作，心力衰竭,或心房颤动)。我们估计了五年的绝对风险，具有95%置信区间(CI)的标准化风险差异和风险比，加权混合逻辑回归，这是一个用于生存分析的离散时间风险模型。进行了几项敏感性分析，包括解决丢失数据的多个插补。
■中位随访时间为4.1（四分位距，1.9-7.8）年。在β受体阻滞剂使用者中，全因死亡率和CVD结局的五年绝对风险分别为4.9%（95%CI，3.8-6.0）和13.0%（95%CI，11.4-15.0），非β受体阻滞剂使用者中的4.0%（95%CI，3.8-4.2）和9.4%（95%CI，9.1-9.7），分别。全因死亡率和CVD结局的五年绝对风险差异和风险比分别为0.9%（95%CI，-0.2至2.1）和1.22（95%CI，0.96-1.54），和3.5%（95%CI，2.1-5.5）和1.37（95%CI，1.22-1.62），分别。敏感性分析的结果是一致的。
β受体阻滞剂治疗与OSA患者的CVD风险增加和死亡风险增加趋势相关。需要进一步的研究来证实我们的发现。
■香港特别行政区政府创新科技委员会。
UNASSIGNED: There is no real-world evidence regarding the association between beta-blocker use and mortality or cardiovascular outcomes in patients with obstructive sleep apnoea (OSA). We aimed to investigate the impact of beta-blocker use on all-cause mortality and cardiovascular diseases (CVDs) in patients with OSA.
UNASSIGNED: We conducted a target trial emulation study of 37,581 patients with newly diagnosed OSA from 1st January 2000 to 30th November 2021 using the IMRD-UK database (formerly known as the THIN database). We compared the treatment strategies of initiating beta-blocker treatment within one year versus non-beta-blocker treatment through the method of clone-censor-weight. Covariates, including patients\' demographics, lifestyle, comorbidities, and recent medications, were measured and controlled. Patients were followed up for all-cause mortality or composite CVD outcomes (angina, myocardial infarction, stroke/transient ischaemic attack, heart failure, or atrial fibrillation). We estimated the five-year absolute risks, risk differences and risk ratio with 95% confidence intervals (CIs) with standardised, weighted pooled logistic regression, which is a discrete-time hazard model for survival analysis. Several sensitivity analyses were performed, including multiple imputation addressing the missing data.
UNASSIGNED: The median follow-up time was 4.1 (interquartile range, 1.9-7.8) years. The five-year absolute risk of all-cause mortality and CVD outcomes were 4.9% (95% CI, 3.8-6.0) and 13.0% (95% CI, 11.4-15.0) among beta-blocker users, and 4.0% (95% CI, 3.8-4.2) and 9.4% (95% CI, 9.1-9.7) among non-beta-blocker users, respectively. The five-year absolute risk difference and risk ratio between the two groups for all-cause mortality and CVD outcomes were 0.9% (95% CI, -0.2 to 2.1) and 1.22 (95% CI, 0.96-1.54), and 3.5% (95% CI, 2.1-5.5) and 1.37 (95% CI, 1.22-1.62), respectively. Findings were consistent across the sensitivity analyses.
UNASSIGNED: Beta-blocker treatment was associated with an increased risk of CVD and a trend for an increased risk of mortality among patients with OSA. Further studies are needed to confirm our findings.
UNASSIGNED: Innovation and Technology Commission of the Hong Kong Special Administration Region Government.
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